K Medical Associates PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

K MEDICAL ASSOCIATES PC

Practice address

55-77 Schanck Rd Ste B-13
Freehold, NJ 07728-2964

Phone

(732) 612-8485

Fax

(732) 612-8483

NPI assigned

Apr 19, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Manish P Khetani, MDNPI 1447430244

Title

Owner

Phone

(732) 612-8485

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23093/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Manish Pravin Khetani, M.D

  • Internal Medicine Physician
  • Freehold, NJ
  • NPI 1447430244

  Single Specialty

  Medicare reassignment NPD Authorized official
• Dinnah Bulosan, APN

  • Adult Health Nurse Practitioner
  • Freehold, NJ
  • NPI 1386415636
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618790400000",
    "number": "1720669088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55-77 SCHANCK RD STE B-13",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282964",
            "telephone_number": "732-612-8485",
            "fax_number": "732-612-8483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55-77 SCHANCK RD STE B-13",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282964",
            "telephone_number": "732-612-8485",
            "fax_number": "732-612-8483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K MEDICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-19",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A",
        "authorized_official_last_name": "KHETANI",
        "authorized_official_first_name": "MANISH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-612-8485",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Grill DPM PC
• Angela Joven, LCSW
• JRM Psychological Services LLC
• Kristine Ann Queng Juan
• Tracey Juron, DO
• Kadora Mental & Behavioral Health Services LLC
• Nidhi Kakar, P.A
• Eduardo Kamatoy, M.D.
• Maria Kaminski
• Michael Robert Kammerer, MD

• Internal Medicine Physician in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.